Vacuum rotary dissector

ABSTRACT

The device is a surgical instrument appropriately termed a vacuum rotary dissector, for purposes of performing delicate surgical operations such as brain operations for removing undesired tissue, etc. A thin elongated tubular member or sleeve which is motor driven, rotates within another elongated sleeve having a bullet-shaped end with a side opening in it. At the end of the inner sleeve, there is a cutout providing side edges which are cutting edges that rotate adjacent to the side opening in the outer sleeve, the tip end of the inner sleeve also being bullet shaped to conform to the interior contour of the tip and of the outer sleeve. The improvements reside in the contours of the tip ends of the sleeves, the particular shape of the side opening in the outer sleeve, and the particular configuration of the cutting edges or surfaces on the inner sleeve. Also, axial pressure is maintained on the outer sleeve to urge its end surfaces into engagement with surfaces of the tip of the inner sleeve.

United States Patent I 72] Inventor Julius C. Urban 10533 Sarah St.,North Hollywood, Calif. 91602 [21 Appl. No. 804,598

[22] Filed Mar. 5, 1969 [45] Patented Nov. 9, 1971 [54] VACUUM ROTARYDISSECTOR 3,6l8,6ll

Primary Examiner-Channing L. Pace A!torney Herzig & Walsh ABSTRACT: Thedevice is a surgical instrument appropriately termed a vacuum rotarydissector, for purposes of performing delicate surgical operations suchas brain operations for another elongated sleeve having a bullet-shapedend with a side opening in it. At the end of the inner sleeve, there isa cutout providing side edges which are cutting edges that rotateadjacent to the side opening in the outer sleeve. the tip end of theinner sleeve also being bullet shaped to conform to the interior contourof the tip and of the outer sleeve.

The improvements reside in the contours of the tip ends of the sleeves,the particular shape of the side opening in the outer sleeve, and theparticular configuration of the cutting edges or surfaces on the innersleeve. Also, axial pressure is maintained on the outer sleeve to urgeits end surfaces into engagement with surfaces of the tip of the innersleeve.

PATENTED NOV 9 l97| sum 1 BF 2 VACUUM ROTARY DISSECTOR SUMMARY OF THEINVENTION The device of the invention is a motorized surgical instrumentdescribed technically as a vacuum rotary dissector. It is an instrumentfor performing delicate surgicaloperations such as brain operationswhere it is necessary to remove undesirable tissues or cut them away indifficult to reachinternal locations.

TI-Ie instrument is of a type embodying an elongatedtubular member orsleeve which is motor-driven by way of a motor mounted in the body of.the instrument which can beheld in one hand. The sleeve which isrotated is the inner sleeve, and it rotates within a second elongatedouter sleeve. The outer sleeve is bullet shaped at the end, that is,ogival in shape. The tip end of the inner sleeve is also bullet-shaped,or ogival, being contoured to engage the inner surfaces of the tip endof the outer sleeve which has a side opening of a particular shape. Thetip end of the inner sleeve has a cutoutfthe sides of which form cuttingedges that rotate adjacentto the side opening in the outer sleeve bywhich the cutting or dissecting operations are performed. A particulartechnique is utilizedas described in detail hereinafter in preparing thecontiguous surfaces to insure that the surfaces of the tip 'end of theinner sleeve closely and precisely engage and arecontiguous to the innersurfaces of the tip end of the outer sleeve. The cutting edge surfacesat the tip end of the inner sleeve are provided each with anintermediate point to insure that these cutting surfaces will cut intothe tissue and not bind or stall.

The inner sleeve is motor-driven by way of a motor embodied in the bodyof the instrument, the outer sleeve being manually adjustable to adjustthe position of the side-opening in the tip end. The outer sleeve isremovable from the instrument and the inner sleeve is similarlyremovable, it having a splined connection to the motor drive means.Means are further provided to normally apply an axial force to the outersleeve to insure that its tip end engages the outer surface of the tipend of the inner sleeve whereby the purposes of the instrument areeffectively and efficiently realized as will be made more clearhereinafter.

The inner end of the inner sleevemakes connections with the motor drivein sealing relationship so that a vacuum can be applied to the bore ofthe inner sleeve and thus enable the instrument to effectively draw awaytissues that have been cut by the instrument. A flexible connection isassociated with the body of the instrument for applying the vacuum.

In the light of the foregoing, the primary object of the invention is toprovide an improved surgical instrument of the vacuum rotary dissectortype, the improvements in effectiveness stemming from uniqueconstructions and configurations of the cutting surfaces and edges ofthe instrument.

Another object is to provide an improved instrument as in the foregoingwherein an elongated sleeve rotates within a second elongated sleeve,the inner sleeve having cutting edges that move adjacent to a sideopening in the tip end of the outer sleeve and each of the cutting edgeson the inner sleeve having an intermediate point to insure effectivecutting into tissues.

Another object is to provide an improved instrument as-in the foregoingwherein the tip end of the inner sleeve is bullet shaped and theinterior contours of the tip end of the outer sleeve is of bullet shapewith these surfaces held in contiguous relationship during operation.

Another object is to provide an instrument having the characteristic asin the foregoing object and means to exert an axial force on the outersleeve to insure that the said surfaces are held in contiguousrelationship whereby to more effectively realize the purposes of thecutting edges of the instrument.

Further objects and additional advantages of the invention will becomeapparent from the following detailed description and annexed drawingswherein:

FIG. 1 is a pictorial view of a tion;

FIG. 2 is a sectional view taken along the line 2-2 of FIG.

preferred form of the invendissector aligned vertically,

FIG. 3 is a view of the tip end of the outer sleeve;

FIG. 4 is a sectional view taken along the line 4-4 of FIG.

FIG. 5 is a perspective view of the tip end of the inner sleeve;

FIGS. 6, 7 and 8 are sectional views taken along the lines 6-6, 7-7 and8-8 ofFIG. 2.

FIG. 1 shows the instrument in a position with the rotary although it isto be understood that the instrumentas shown may be gripped like apistol, and in use, the dissector stem may extend in any direction, butmore usuallyin a generally horizontal direction.

The instrument embodies a cylindrical body 10, having an end closure 12,of smaller diameter to which flexible electric cable or cord 14 isconnected for supplying power to the motor. At the end of thecylindrical housing part 16 is a flange part 18 with scalloped edges tofacilitate unscrewing the motor housing 16. The end of the housing 16 isthreaded onto a threaded boss from which extends an integral cylindricalpart in which is received the shaft of the motor that drives theinstrument. At the end of the cylindrical part is an end cap 22 held onby a small screw 24. Integral with this extending cylindrical part isthe cylindrical body 28 which houses the drive mechanism for thedissector. The shaft of the motor 16 drives worm 30 which is within thecylindrical portion 20, and this worm meshes with a gear 32 which willbe described more in detail presently.

The body part 28 of the instrument comprises a cylindrical barrel part36. At the upper end of this barrel part is a bore 38 in which isreceived a fitting 40 having an upper tapered part 42 providing anannular shoulder 44 that fits against the upper end of the barrel 36.Numeral 48 designates an annular counterbore in which is a sealingO-ring 50 that seals the fitting 40 in the end'of the barrel 36. I

The fitting 40 has an angled fitting or nipple 52 which is externallyribbed, as shown at 54, to receive a flexible tubular connection Thefitting 40 has a bore 56 whereby vacuum may be applied to the interiorof the instrument, as will be described. The fitting 40 has a larger endcounterbore 60, and numeral 62 designates a channel in the side wall ofthis part of the fitting 40. The fitting 40 is held secure in the bore38 by means of the setscrew 64. At the end of the bore 38 in body 36 isa counterbore 70 which receives sealing O-ring 72, this counterborebeing adjacent to a smaller bore 74 that connects to a larger channel 76in the body 36. The bore 62 in the fitting 40 registers with atransverse bore 78 in the body 36, which is for purposes of controllingthe degree of vacuum applied to the interior of the instrument and whichis controlled by a manually actuated valve member or shutter 80, whichwill be described more in detail presently.

In the lower end of the bore 76 is a head or fitting '82 which has anend part 84 that engages against the end of the body 36 and a portion 86of smaller diameter that fits inside of the bore 76. The fitting 82 hasan extending end or flange part 90.

Numeral 92 designates a bushing that is aligned 'within bore 76 and onwhich is mounted the gear 32, this bushing having a bore 94. Numeral 96designates a bushing made of a synthetic material such as Teflon ormaterial of similar type which does not require lubrication which fits"within the bore 76. This bushing has a bore 100 within which an endpart of the bushing 92 fits. The end of the bushing 96 adjacent to thegear 32 is tapered as shown at 102, so as to eliminate unnecessaryfriction between the bushing and the gear. Numeral 104 designates abushing that is similar to the bushing 96 on the opposite side of thegear 32 and fitting in the bore 76, and it having a similar bore 106. Asmay be seen, the Teflon bushings provide a substantially frictionlessrotary mounting for the bushing 92 that carries gear 32 and one thatdoes not require lubrication or maintenance.

Numeral designates the outer elongated sleeve of the vacuum dissector.The inner end of the sleeve is enlarged as shown at 122 and it has athreaded part, as shown at 124, the threaded end being threaded into athreaded bore 126 in fitting 128, which engages with the fitting 82 inthe end of the body 36 as will be described.

On the inner end or side of the fitting 128, it has a boss 130 that fitsinto the bore 130 in the fitting 82 and it can be held in the bore byspring detents as will be described. A sea] is provided in a smallcounterbore 134 at the inner end of the threaded bore 126. The outerpart of the fitting 128 as designated at 138 is of larger diameter andbetween this part and the boss 130 is a flange 140. Received on theouter part or boss 138 is a manual rotating knob or disc 142 having abore 144 that receives the boss 138 and to which the knob 142 is securedby a setscrew 146 in radial bore 148. The enlarged part 122 at the endof the outer sleeve 120 is in a bore or counterbore 150 in the boss 138which is of slightly larger diameter.

As may be seen in FIG. 8 the boss 130 of fitting 82 has three radialbores 154, 156 and 158 which are equally angularly spaced and in whichare biasing springs 160, 162 and 164. These springs act against balls166, 168 and 170 which cooperate with recesses or depressions that arecomplimentary to the spherical balls in the sidewalls of the boss 130 asdesignated at 172, 174 and 176. The balls and the recesses from springdetents which releaseably hold the fitting 128, and knob 142 and outersleeve 120 in position, that is in a position which allows release andremoval. In the lower end surface of fitting 82 there is provided atransverse groove 180 in which is received a yoke or slide 182 whichconstitutes one arm of a bellcrank lever 184 which has another arm 186that extends adjacent to body 36 and the outer end surface of which isknurled as shown at 188 to adapt it to be engaged by the thumb. Thebellcrank lever 184, as may be seen by exerting a slight inward push onthe arm 186, is rotated so as to rotate the arm 182 and push downwardlyslightly against the surface of flange 140 so as to push the assembly ofknob 142 and the fitting 128 and the outer sleeve 120 outwardly so as torelease the engagement of the ball detents as described in connectionwith the FIG. 6 and allow the said assembly to be removed. Otherwisethis assembly is held in position as described.

Numeral 200 designates the inner sleeve of the rotary dissector. Itrotates within the outer sleeve 120. The tip end of the outer sleeve isbullet shaped or ogival, this tip end being designated at 202. The tipend of the inner sleeve 200 is of similar shape as designated at 204,that is ogival, so that it fits into the inside of the tip end of theouter sleeve with the surfaces mutually contoured to be in engagementwith each other. The tip end 202 of the outer sleeve 120 has a sideopening as shown at 206 which is of slightly less than 180 in lateralextent and the upper and lower sides of which are of configuration asmay be seen in FIG. 3. The tip end of the inner sleeve 200 has a sideopening also as designated at 208 and the side edges of this openinghave a particular contour as will be described. These side edged aredesignated at 210 and 212 in FIG. 3.

The cutting edge 210 has an intermediate point 214 and the cutting edge212 has an intermediate point 216 which points serve the purposes ofinsuring that the edges will cut into the tissue being dissected withoutbinding or stalling of the sleeve 200. The particular shapes of the tipends of the sleeves contribute to the realization of it being possibleto maintain the cutting edges on the inner sleeve. Maintenance of theseedges requires a seal between the surface of the tip end of the innersleeve and the inner surface of the tip end of the outer sleeve, thatis, that these surfaces are in contiguous engagement during operation.In preparing these surfaces, they are lapped with lapping compound whichis then removed. No air space remains between these surfaces and theinner sleeve is able to rotate effectively maintaining the cuttingsurfaces without rotation of the outer sleeve.

At the inner end of the sleeve 200 it has a part 220 of slightly largerdiameter that is received in the bore 94 and this end passes through thebore 74 and is sealed by the O-ring 74. Sleeve 200 itself, has a bore222 which communicates with the bore 60 as shown in FIG. 2. At the innerend of the enlarged part 220 of the inner sleeve, there is a collar 230which has a group of spaced axial spline grooves 232, there being fourof these grooves as may be seen in FIG. 5. At the end of the bushing 92it has four equally spaced axially extending members or splines 234 thatengage in spline grooves 232. Thus, when the spline members are broughtinto engagement axially as may be seen, the bushing 92 will drive, thatis, rotate the inner sleeve 200.

The manual control or shutter valve is of angular configuration as maybe seen in FIG. 1 and in FIG. 6, having a flat surface 240 that fitsagainst a fiat side surface on the body 28. It has another surface part241 including portions at a slight angle to each other and lying inplanes substantially normal to the plane of the part 240. The part 240is pivoted to the flat side surface of the body 28 on screw or pivot pin242, a part of the surface 240 lying adjacent to the end of the orificeor channel 78 so as to control the degree of vacuum within theinstrument.

The effect of the balls 166, 168 and 170, as described in connectionwith FIG. 6, is to urge the part and the assembly comprised of fitting128 and knob 142 and the outer sleeve 120 axially inwardly so that theinside surface of the tip end of the outer sleeve 120 is urged againstthe surface of the tip end of the inner sleeve.

From foregoing, those skilled in the art will understand the operationof the device. The body 10 provides a pistol grip and the instrument maybe gripped in this manner by the surgeon and the stem formed by theinner sleeve 200 and outer sleeve 120 may be pointed or extended in anydirection. The angle between body 10 and stem 120 is slightly greaterthan 90. The motor is energized for a driving worm 30 which drives thehelical gear 32 and consequently the inner sleeve 200 as described inthe foregoing, the drive being virtually frictionless and requiring nolubrication. Vacuum is applied to a flexible tube and by way of nozzle52 to the interior of the instrument and to the interior of the innersleeve 200. The degree of vacuum is controlled by manual adjustment ofthe shutter valve 80 by the surgeon's thumb. The tissue is cut atwhatever point the operation is being conducted by the rotation of thecutting edges 210 and 212 and points 214 and 216 adjacent the innersurfaces of the tip end ofthe outer sleeve 120, that is, adjacent to theopening 206 which, as stated, has a lateral extent of less than so thatone of the cutting edges is always passing a part of this opening. Thevacuum serves to draw the tissue to be cut into the opening, the degreeof vacuum being adjusted as necessary to perform this function and toremove the cut tissue. The points 214 and 216 insure that the cuttingedges will cut into the tissue without binding. By reason of theconfiguration of the tip ends of the inner and outer sleeves asdescribed, the cutting edges can be maintained and the cutting edgesoperate adjacent to the opening 206 in such a way as to insure thedesired efiectiveness of the instrument. The outer sleeve can be removedas described simply by exerting pressure on the arm 188 of bellcranklever 184 sufficient to overcome the ball detents to allow them torelease for withdrawal of the boss 130.

From the foregoing, those skilled in the art will understand andappreciate the construction and operation of the device of the inventionand the manner in which it achieves and realizes all of the objects andadvantages as outlined in the foregoing, as well as the many additionaladvantages that are apparent from the detailed description.

The foregoing disclosure is representative of a preferred form of theinvention and is to be interpreted in an illustrative rather than alimiting sense and the invention to be accorded full scope of the claimsappended hereto.

I claim:

1. A surgical instrument comprising;

a support;

an outer tubular member extending from said support and having a closedgenerally hemispherical distal end and a first laterally directedopening adjacent its distal end and extending axially along said outertubular member and partially along said generally hemispherical end;

an inner tubular member rotatably mounted in said outer tubular memberand having a complementary generally hemispherical end frictionallybearing on an inner complementary surface of the distal end of saidouter tubular member; said inner tubular member having a secondlaterally directed opening axially coextensive with said first openingand defining generally axially extending cutting edges coincident withthe inner surface of said outer tubular member; drive means on saidsupport for continuously rotating said inner tubular member relative tosaid support and said outer tubular member; and biasing meansresiliently urging said tubular members axially relative to each otherto maintain said hemispherical ends in close surface contact. 2. Aninstrument as defined in claim 1 wherein said cutting edges include apointed portion axially intermediate the ends of said openings.

3. An instrument as defined in claim 1 including means for applyingsuction to the interior of said inner tubular member.

4. An instrument as defined in claim 3 including means for selectivelyvarying the degree of suction.

5. An instrument as defined in claim 1 including means for selectivelyrotating said outer tubular member relative to said support to directsaid first opening in a selected direction.

6. An instrument as defined in claim 1 wherein said cutting edges are onopposite sides of said second opening and wherein said drive means arereversible.

7. An instrument as defined in claim 1 wherein said biasing meanscomprise spring-urged ball detents on said support engageable withrecess means on said outer tubular member, said ball detent means alsoreleasably holding said outer tubular member on said support.

1. A surgical instrument comprising: a support; an outer tubular memberextending from said support and having a closed generally hemisphericaldistal end and a first laterally directed opening adjacent its distalend and extending axially along said outer tubular member and partiallyalong said generally hemispherical end; an inner tubular memberrotatably mounted in said outer tubular member and having acomplementary generally hemispherical end frictionally bearing on aninner complementary surface of the distal end of said outer tubularmember; said inner tubular member having a second laterally directedopening axially coextensive with said first opening and defininggenerally axially extending cutting edges coincident with the innersurface of said outer tubular member; drive means on said support forcontinuously rotating said inner tubular member relative to said supportand said outer tubular member; and biasing means resiliently urging saidtubular members axially relative to each other to maintain saidhemispherical ends in close surface contact.
 2. An instrument as definedin claim 1 wherein said cutting edges include a pointed portion axiallyintermediate the ends of said openings.
 3. An instrument as defined inclaim 1 including means for applying suction to the interior of saidinner tubular member.
 4. An instrument as defined in claim 3 includingmeans for selectively varying the degree of suction.
 5. An instrument asdefined in claim 1 including means for selectively rotating said outertubular member relative to said support to direct said first opening ina selected direction.
 6. An instrument as defined in claim 1 whereinsaid cutting edges are on oPposite sides of said second opening andwherein said drive means are reversible.
 7. An instrument as defined inclaim 1 wherein said biasing means comprise spring-urged ball detents onsaid support engageable with recess means on said outer tubular member,said ball detent means also releasably holding said outer tubular memberon said support.